QUESTION: I have suffered from dry mouth for several years, but only recently have become aware that my eyes always seem too dry as well.
My neighbor believes that these two conditions are related and that there may be some help available.
Can you tell me what this might be and what I must do to correct it?
ANSWER: The combination of these two symptoms, dry eyes and a dry mouth, may well indicate that you have a condition known as Sjogren's Syndrome (SS).
SS is, after rheumatoid arthritis, the most common disease of the connective tissues.
It either occurs on its own in its primary form or in its secondary form accompanying another specific and well defined rheumatic disease such as rheumatoid arthritis or systemic lupus erythematous. The condition is caused by lymphocytes and antibodies from the bloodstream infiltrating the glands that produce tears and saliva and in effect drying them up.
Loss of tears is known as xerophthalmia, and lack of salivation is called xerostomia.
In tandem, the two are referred to as the "sicca complex." (Other conditions may cause this complex, including aging and drug use.) Women sufferers of the syndrome outnumber men by nine to one.
While the condition usually occurs in the individual's fifties, it may develop during adolescence or early adulthood.
The syndrome is more readily diagnosed in its secondary form, where the presence of a recognizable rheumatoid condition helps tip doctors off to its presence.
In its primary form, it may come and go and be hard to pinpoint. As you can imagine, lacking the ability to shed tears or produce saliva can lead to more than a small amount of discomfort.
The eyes may be subject to a gritty or filmy sensation from real or imagined foreign particles, as well as to general eye fatigue.
As the xerophthalmia develops, erosions and ulcerations can develop in the surface of the unprotected eye. A dry mouth can lead to a sense of burning discomfort, and a decreased ability to chew and swallow food.
The tongue and lips can develop fissures, while the senses of taste and smell can diminish or vanish entirely.
The dryness can also spread to nose and throat, compounding the discomfort experienced.
All this in addition to a variety of other pains and aches that may occur in connection with the syndrome. In primary cases of the syndrome, artificial tears can help minimize the discomfort of xerophthalmia; diving goggles are even worn at night to help retain eye moisture.
When this does not help, soft contact lenses, kept well hydrated by frequent applications of saline drops, may yield the necessary relief.
Xerostomia is easier to treat by sipping fluids throughout the day, chewing sugarless gum or using a a 2% solution of methylcellulose as a mouthwash.
It would be wise to increase the level of humidity in your home by using a humidifier. In cases of secondary Sjogren's syndrome, the main line of attack is to treat the specific disease the syndrome accompanies.
This requires a complete history and examination by your physician.
He or she may find that you have some involvement of your joints, as this occurs in about 1/3 of all patients with SS.
The good news is that this form of arthritis is milder than rheumatic arthritis, and rarely leads to joint destruction.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
